Posted on November 18, 2013


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Nick King, NEHI
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Tele-ICUs Poised for a New Wave of Expansion 

NEHI report details best practices driving scalability, diversity and competition
for telemedicine in intensive care units 

CAMBRIDGE, MA (November 18, 2013) - The use of tele-medicine in intensive care units is on the threshold of major change, with emerging best practices providing valuable precedents and guidelines for adopting tele-ICU care more broadly around the country, according to a report published today by the national health policy institute NEHI.  

Many of the recent models of tele-ICU care reflect variations in practices that have the potential to make the technology more scalable and accessible in a variety of new settings including county, public, rural and critical access hospitals, according to the NEHI report, Emerging Best Practices for Tele-ICU Care Nationally. In the past few years, NEHI said, new product and provider options have emerged, as well as new efficiencies, which together are likely to drive broader adoption of these networks of audio-visual communication for monitoring ICU patients remotely.

“The use of tele-ICU care is entering a second phase of adoption,” said NEHI president Wendy Everett. “And as more tele-ICUs are implemented, the need for best practices to guide this expansion is critical.”

NEHI identified six critical best practices that provide valuable data and experience for successfully implementing tele-ICUs more widely around the country:

  • Establish pre-coverage benchmarks prior to tele-ICU implementation. By gathering baseline data six months before tele-ICU initiation, as John Muir Health did in California, executives can better assess where improvements have been achieved post tele-ICU and where more implementation work is needed.
  • Extend coverage to hospitals unaffiliated with the monitoring center.  A number of monitoring centers, including the University of Wisconsin Health and Christiana Care Health System, have used creative practices to support the care directed by clinicians in a different health system.
  • Rotate clinicians through bedside and monitoring center shifts. This practice of rotating clinicians through both ICUs and the support centers limits opportunities for “us versus them” friction among staff, improves their clinical skills and broadens their perspectives.
  • Cover critical access and rural hospitals. Tele-ICUs offer a potential solution to the lack of coverage for public and safety-net hospitals around the country, as Avera Health and Maine Medical Center have proven.
  • Extend coverage outside of the ICU through wired beds and mobile carts. Using the tele-ICU monitoring center to extend coverage to seriously ill patients in other departments of the hospital and to post-discharge settings is an approach being used around the country to support both small, isolated hospitals and crowded urban hospitals.
  • Make a business of “renting” tele-ICU coverage to hospital clients. Several vendors have pioneered using tele-ICU coverage as a contract service to third party hospitals and medical centers. 

This new report is the latest in a series of NEHI research projects assessing the clinical and financial benefits of tele-ICUs. In 2010, NEHI published the groundbreaking work, Critical Care, Critical Choices, the Case for Tele-ICUs in Intensive Care.  


About NEHI 
NEHI is a national health policy institute focused on enabling innovation to improve health care quality and lower health care costs. In partnership with members from all across the health care system, NEHI conducts evidence-based research and stimulates policy change to improve the quality and the value of health care. Together with this unparalleled network of committed health care leaders, NEHI brings an objective, collaborative and fresh voice to health policy. For more information, visit or follow us @NEHI_News.

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